Isolated Plantar Vein Thrombosis Resembling a Corn with a Bruise

Abstract

Plantar vein thrombosis, rarely-reported disease, is usually accompanied by pain and tenderness in the plantar region and should be differentiated from other dermatological conditions causing plantar pain, such as hemorrhagic corn/callus, plantar epidermal cyst, verruca, or plantar fibromatosis. A 52-year-old man presented with a violaceous tender subcutaneous nodule overlying a hyperkeratotic plaque on his sole. Initially, he thought it was a corn and applied keratolytic agents, which failed to work. Sonography revealed a well-demarcated mass with increased peripheral vascularity. His pain was relieved after a complete wide excision, which confirmed the mass to be plantar vein thrombosis after histopathological examination.

Keywords: Corn; Plantar vein thrombosis; Venous thrombosis.

Fig. 1. (A) A bruise-like violaceous nodule 2.5 cm in diameter, on the heel side of the right sole. (B) A dark reddish rubbery, lobulated nodule in the subcutaneous layer.

Fig. 2. A 1.9×1.2 cm sized, well-marginated, lobulated, heterogeneous hypoechoic mass surrounded by a thin anechoic area with increased peripheral vascularity.

Fig. 3. (A) Several variable thick and plicated walled small muscular vessels in the dermis and its abutting thrombus consisting of aggregated erythrocytes and eosinophilic fibrin in the lumen of a dilated vein in the subcutaneous layer (H&E, ×10). (B) Granular bluish deposit (hemosiderin) within and around mural walls of muscular vessels (Iron stain, ×20).